The challenge was inevitable,but the decisions were tough to make. Doctors dairy
Doctors takes decisions and patient takes the risk. For every wrong step we take,she might just slip away from us.
Our venesection line in leg was shifted to arm to decrease risk of infection.Drugs to maintain BP was continued. We started broad spectrum antibiotics(acting on most of organisms) and sent pus for culture-sensitivity,which will help choosing appropriate antibiotic therapy.
Her kidneys were shutting down due to toxins in blood.we finally were able to keep her kidneys perfused through drugs and prevented kidney failure.
Our big concern was large the wound on her tummy..next day in Operation theatre, we closed the wound 3/4th and left 1/4th of it open to allow pus drain out and to prevent raise of pressure inside her tummy.
A big tube was put into tummy for pus to come out through it, so can we can further make the wound dry.
4 days post admission, now her BP started picking up and she started to maintain normal BP without drugs.It was a big ray of hope.
Around a week, we started seeing some respiratory efforts and her neurological recovery started appearing.
We were very happy. It’s an absolute pleasure to see your patient getting well by your interventions.
It was time to thank god and feel proud.we went for a dinner after a tiresome week.
People say “never celebrate a half victory”.. something terrible was waiting for us next day.
Suddenly,patient started having difficulty with breathing. Oxygen level in her blood was going low.And apparently we couldn’t find any cause at that moment.
In few mins, she was in a cardiac arrest.Her heart stopped beating. A moment of shock and panic for an intern..shouted sister to call anesthetist and started CPR (manually compressing chest to maintain blood flow).
Further, doses of adrenaline and amiodarone made her heart to beat strong and regular. Anesthetist took over and after few mins of resuscitation, she was back to life.
It was time to reacess..her brain injury due to less oxygen all these time.
Poor GCS, unresponsive reflexes, no respiratory efforts.she was back to zero again.
Its half an hour post her cardiac arrest…we haven’t left the hope.. searching intensely what caused her cardiac arrest..
Read further for final saga.